Recently, the band that I’m in, Downtown Boys, played in Winooski, Vermont. On the four-hour drive back home to Providence, we stopped at a gas station, where an elderly man was working all by himself. We struck up a conversation with him when we bought a lotto scratcher and made a joke about needing to win to afford health care in a few weeks. He told us that we were all wrong to think that repeal of the Affordable Care Act was a bad idea. He told us that once we stopped being “cash cows” and actually started working, we would realize how expensive it is to have health care through the ACA. He was stuck on the fact that if you don’t enroll for health insurance, you are fined when you pay your taxes. (In many ways, this incentivizes enrollment.)

There were so many things to say. Downtown Boys’ guitar player, Joey DeFrancescowas the most straightforward:“I have family members who would probably be alive right now if they had the ACA.”

There was no need for our guitar player to share this with a Trump sympathizer in rural Vermont. But I’m glad he did. He cut an incision into the fabric of the man’s ignorance—the same ignorance that the current presidential administration uses as fuel to dehumanize and endanger the sick, poor, and nonwhite people of the U.S. As the Senate GOP prepares to release their most recent bill for the House to vote on next week, these conversations are rapidly becoming all the more urgent.

The ACA has provided everyday medical care to millions. Under the ACA, “As many as 129 million Americans who have some type of pre-existing health condition, including up to 19 million children, are […] protected from coverage denials and reduced benefits—practices that were routine before the law’s enactment.” 129 million people is over half of the United States’ population. For one of them, my bandmate Mary Jane Regalado, “The ACA was not enough to provide [some forms of medical] security, but it was important to me. Without it, I wouldn’t have been able to afford going to the hospital after being in a car accident or seeking treatment for depression/anxiety and chronic pain.” As musicians, public health care is essential to our lives. The more that we put a voice to the facts, the real news, the undeniability that we need health care, the more that we realize we are up against.

We are looking at a great regression. About this time last year, I called and wrote emails to every doctor at Stanford Hospital, begging them to see my godfather as a test patient because he had an intricate sickness stemming from decades of Medicaid that medicated him as much as possible, but never really seemed to seek a cure. By the time we finally got him an appointment, it was too late. The tests he needed were impossible because his body was so sick. When I learned about his death, I remember thinking, with a broken heart, how one day I would fight for a better Medicaid system. A year later, I am waking up thinking about how to save the only healthcare system we have.

While there is no one like my godfather, his story may be familiar to you. Our healthcare system, which is determined by our economic system, leaves people to die. An ACA repeal will make this far worse. The problem is capitalism’s reduction of human existence to a market in which our self-worth is dependent on a stakeholder’s profits. Tess Brown Lavoie of Mother Tongue told me, “One of the first things that I read about the recent ACA news was about ‘removing sick people from the market.’ This was code for ‘removing sick people from the world.’ The logic driving the repeal of the ACA is, the market says I should not be alive. People should not need a combination of privilege and luck to live.” It is about time we realize our ancestries, realities, and futures are the real stakeholders, not some suit that is threatened by the power of the people.

So long as we live with capitalism and racism, the contradictions within any political fight, and therefore any victory, are immense. “Obamacare” was really a watered-down, negotiated version of what Obama originally presented to Congress. Carved out of it: care for undocumented people who contribute nearly $12 billion in taxes to the economy every year, as well as expanded Medicaid in all states. Sure, it should be called “Romneycare” considering how many concessions were made for it to pass. And, yes, the ACA is not substantial enough to save a lot of lives—like my godfather’s. At the same time, try telling people who can now take one pill a day to fend off death that their life-saving care might be hacked away by a fascist President and Congress. “The ACA has many problems, but the current alternatives proposed by this administration are deadly for millions of Americans,” says Enongo Lumumba-Kasongo, aka SΔMMUS.

The current president and Congress can’t consider our existence, our survival—even our next breath. They can’t consider something they don’t even believe in—the well-being of the very people they mean to govern.Franklin Fisher of Algiers says, “That none of the opponents to the ACA question the foundations or mechanisms of our (ultra)capitalist society is the insidious residue of what Antonio Gramsci refers to as cultural hegemony.” Meaning: Republicans do not consider poor or disenfranchised people to matter, because their only interest is protecting their own status and wealth (and health).

Sicknessgets inside of us in so many ways—genetics, transmission, trauma, distress from other sickness. The fascist regime laid out a death threat to millions of people, and an even more imminent death threat if you have a “pre-existing condition,” which they may have well just called “a lived experience outside of having a nearly robotic body or if you aren’t privileged enough to be related to a federal congressperson.” The last public Republican health care plan’s list of “pre-existing conditions” included so many sicknesses that can be symptomatic of racism and classism, since they’re dependent on what resources a person lacks. (Just one example: Asthma can be a symptom of growing up in an environment with a lot of pollutants and smog, or being born to someone who was while they were pregnant.) “Our black and brown communities are already suffering from an unjust lack of access to basic health care. Getting rid of ACA will be even more devastating to the most vulnerable people in our society,” says Taina Asili.

The repeal of ACA will make so many more of us much more vulnerable, across the board. “There is definitely an idea or stigma that only really people or working class people need healthcare, but really a lot of lower–middle class working people and artists and musicians depend on it, too,” says Norlan Olivo, Downtown Boys’ drummer. “It’s not just a ‘black’ and ‘white’ issue—poor, white people need Obamacare, too! Especially a lot of the lower-class white people who voted for Trump.”

It was hard to ask people to tell me about their experiences with health care, since so many of us are probably affected in ways that I don’t realize. But our, and your, voices are needed in order to fight the diseased policies and systems that are looking to revoke care for millions—especially if you care about the arts, since so many musicians solely rely on the ACA for medical coverage. SΔMMUS says, “I’m constantly stressed about how I will care for my health once I graduate from Cornell, particularly as a woman who has dealt with chronic respiratory issues for the better part of the past decade. Honestly, sometimes it feels like it would be easier to give up on music and pursue employment that will cover the costs of my health care.” If that resonates with you, as a musician or a fan, it’s time to call your congresspeople in advance of next week’s probable vote on the new bill. Here’s an easy tool and script for finding and contacting your representative instantly, and here’s a directory of numbers and other script ideas.

If not for yourself, then do it for someone you love—or for many someones. “The lack of understanding and power against this particular system has literally cost my family members [their] lives,” says Bean Kaloni Tupou of Try the Pie. “I don’t want to say that my family is special. I know that this happening all over our country.”